For the last several years, the electronics industry has been promoting the improved image quality provided by high-definition (HD) devices. Walk into virtually any electronics store these days and you'll hear terms such as high-definition multimedia interface (HDMI), high-definition television (HDTV), and high-definition video (HD video) used when describing monitors, televisions, and camcorders. The world of high definition also carries over to the smartphone and tablet industry. In June 2010, Apple introduced the Retina display on the iPhone 4, which is described as using a pixel density so high that "your eye is unable to distinguish individual pixels." HD has found its way into the video magnifier arena for people with low vision as well. The IBIS HD video magnifier, designed by the Danish company Tagarno, and distributed in the US by The Low Vision Store in Vancouver, WA, is one such product.

All video magnifiers perform the same core function: they project a magnified image onto a display via a video camera. Choosing a video magnifier that is right for you depends on a number of factors, such as your functional vision, the range of daily tasks performed in a given environment, your lifestyle, and, last but not least, your pocketbook. Choosing this type of tool can be a personal and highly individualized decision. If you'd like to get a sense of what's currently available in the video magnifier market, read the AFB overview of video magnifiers.

Caption: Screen shot of IBIS HD and the three available color choices

Physical Design

The IBIS HD weighs slightly more than three pounds, and includes a thinly padded carrying case, a power adapter, a manual, and HDMI and DVI cables. The device is available in three colors: red, blue, and silver-grey. The unit folds up into a compact size (roughly that of a small umbrella), which makes it easy to carry and store in a suitcase or backpack. It does not come with an X-Y table, nor the required HD monitor or HDTV, though both are available as separate purchases from The Low Vision Store and other outlets. For this article, the IBIS HD was used in combination with a Samsung 22-inch HD monitor.

The solid base of the IBIS HD firmly secures the lightweight device while in use. The IBIS HD camera is located a little more than nine inches above the base surface, which allows for an ample amount of maneuverability for tasks requiring additional space and hand movement such as knitting or sewing. The IBIS HD is also equipped with two well-positioned lights located on the underside of the extended arm, which allow for an effective balance of illumination without an increase in glare.

The on/off button is located on the base of the unit. All other controls are clustered in a circular pattern on the back of the housing of the camera, which means the controls face away from you while the device is in use. This design is peculiar, particularly since this product is marketed for people who are interested in using their functional vision. The Up and Down controls allow you to adjust the level of magnification, and the Left and Right controls allow you to cycle through the available color schemes, which include natural colors, white/black, yellow/blue, and yellow/black. The Center control inverts the three color schemes and provides varying levels of contrast for each. The IBIS HD camera is designed specifically for viewing material positioned below the camera, and does not allow for distance viewing.

Set Up

To set up the unit, unfold it, plug in the power supply, and connect it to an HD monitor or HDTV with either the HDMI or DVI cable included with the unit. Some portable video magnifiers of this category use the power supply from a computer USB, or a battery backup. The IBIS HD relies exclusively on an AC power source, so a wall outlet in close proximity is required to use the device.

Although this video magnifier is small and compact, the IBIS HD is not able to interface with a laptop computer, such as the Transformer USB by Enhanced Vision. The solid base of the IBIS HD firmly secures the device while in use. This is significant, considering the fact that the unit only weighs 3.3 pounds.

Documentation

The manual that comes with the IBIS HD effectively describes and lays out the operation of the device. The title at the top of each page of the manual is displayed in clear, large font (approximately 26-point font). The text portion of the manual varies between approximately 14- and 16-point font. It is clear that an effort has been made to increase the font size from what is typically found in mainstream technology manuals. Increasing the font size of text to 18- to 22-point would provide an even greater level of accessibility. Several diagrams illustrate how to unfold and fold the device, describe the function and shape of the various controls, and the connection of the power supply. These diagrams are small, and will be difficult for many people with low vision to see without the use of a magnifier. Increasing the size and boldness of the diagrams will also increase the manual's accessibility.

Features

Magnification

According to the manufacturer's specifications, the IBIS HD is capable of a magnification range of 2 to 40 times when using a 19-inch monitor.

High-Definition Capability

The strongest selling feature of the IBIS HD is its HD capability, which allows the device to provide a very clear image, even at higher levels of magnification. The camera itself is 720p, which means that 720 lines can be displayed on the screen at one time (a standard monitor typically displays 480 lines). The "p" refers to the progressive rendering of the image, which ultimately translates into less motion blur, or ghosting. So, when a page of text is moved from side to side or up and down, the clarity of the displayed text remains sharp. The lack of motion blur with the IBIS HD is impressive, and may result in using a lower level of magnification than you might need with another video magnifier.

We found that for detail-oriented tasks, the IBIS HD high-definition capability is extremely effective. When it comes to reading, however, we found that the IBIS HD provides the greatest benefit to people who are able to access printed materials at a lower level of magnification. If the level of magnification you require only allows for a few letters or words to be displayed on the screen, an HD video magnifier will have little impact on improving the quality of your reading experience.

Auto-Focus

As is standard with most video magnifiers in this price range, the IBIS HD is equipped with auto-focus. The contrast level available using the Samsung HD monitor in combination with the IBIS HD is very high, which is an important consideration for many eye conditions such as macular degeneration and diabetic retinopathy.

Caption: Screen shot of IBIS HD Controls

The Bottom Line

Though the HD capability of the IBIS does not result in an improved reading experience for those who require a high level of magnification to see text, if you perform tasks that require a higher level of detail and clarity, the IBIS HD may be worth considering.

This unit is not ideal for a student in a school setting moving from one classroom to another, since it's dependent on an HD monitor or HDTV and an external power supply, and is not capable of distance viewing.

The IBIS HD has a simple, straightforward design, with few controls. For people who are more visually dependent and/or who may have difficulties with memory or tactual discrimination, the location of the device controls may be problematic. Repositioning the controls on the front of the camera and applying high-contrast labels on the controls themselves would improve the ease of operation for a broader population.

When the IBIS HD is turned off the unit automatically resets to the smallest level of magnification. If the IBIS HD could retain its previously used settings, it would simplify operation and make using the device faster.

As mainstream technology for video cameras and monitors continues to advance, the improved image quality available with video magnifiers will undoubtedly follow suit. The quality of the image that the IBIS HD produces in today's market makes it a serious contender in the arena of high-end video magnifiers.

Product Information

Product: IBIS HD

Price: $2,995 plus $55 shipping
(Ken Twergo of The Low Vision Store states that he has seen success pairing the IBIS HD with both Samsung 19-inch and 22-inch HD monitors, which generally retail for between $130 and $200.)

Available From: The Low Vision Store

Address:
300 NE 117^th Ave.
Vancouver, WA 98684

Phone: (888) 216-1912

E-mail:info@thelowvisionstore.net

Manufacturer's Response

Everyone who is determined to make maximum use of their remaining vision knows the frustration of trying to see and remember tiny controls on portable electronic devices. Even big CCTVs with large buttons challenge vision and memory for some, causing often persistent uncertainty about what control does what.

IBIS HD engineers confronted the challenge of [designing] workable controls on [a small device by] removing the temptation (which becomes an obligation) to look. The resulting controller and its placement are not, in my view, peculiar at all. Our experience introducing IBIS HD to end users, many quite elderly, has been that the controls are easy [to use]. They are easy [to use] because the controller invites the fingertips of one hand to awaken "the mind's eye" on a simple, tactile wheel (think of it like a clock face) that is [quickly located] and efficient to operate with two or three fingertips.

The user does not have to look for the controls and is therefore freed to use their vision to observe in an instant the adjustments they have made on the screen. After one or two tries, just about everyone gets it as they keep their eyes focused on the screen changes. A slight grip with the hand (either left or right) on the camera head provides additional stability for fingertip operation.

The suggestion to place the controller at the front might sound smart on its face, but such a placement would require a less reliable and more awkward thumb operation with a bent wrist while diverting the eye away from the screen where the printed information resides.

While the evaluator's comments about student needs might be true for some students, there is to our knowledge no sharper image than IBIS HD on any [portable] electronic reading device. Additionally, the flexibility of IBIS HD connectivity to either an HD computer monitor or HDTV, of any size, opens up educational and workplace applications in many settings. Low-vision workers who have chosen IBIS HD value [the ability to] take the camera home at night, or have multiple monitors at work to accommodate the multiple workstations of their job. […] IBIS HD is [a game changer because it offers] easy transport and stunning image clarity, with a working depth of field that has simply not been seen before in the US market.

Thank you,

Ken Twergo, The Low Vision Store

Comment on This Article

Dear AccessWorld readers,

Last month AccessWorld celebrated the birthday and life's work of Louis Braille. I hope everyone had a chance to visit The Louis Braille Museum on the AFB website, and read The Reading Fingers, the full text of Jean Roblin's classic 1952 biography of Louis Braille, and Braille, the Magic Wand of the Blind, Helen Keller's essay on Louis Braille. If not, I encourage you to take a look at these great works.

In this issue, in addition to two low-vision product reviews, we revisit the accessibility of at-home diabetes testing equipment, learn about a woman expanding access to people with vision loss in Rwanda, take a look at access to museums and parks, and continue Paul Schroeder's series covering trends altering the design and use of information and communication technology.

Also in this issue, be sure to read AccessWorld News, where among other timely tidbits you will find information about the lawsuit against Redbox claiming it discriminates against the blind by failing to provide accessible self-service kiosks. Also in the News, you'll find information about academic scholarships offered by the American Foundation for the Blind and the National Federation of the Blind.

I'm also excited to announce the 1.8 version update for the AccessWorld app has been released! In this version we've added two new features several readers have requested:

1. An option to customize the size of the text within the article view.
   To change the text size, navigate to the newly added "More" tab and select the preferred article text size.
2. A button to let readers e-mail AccessWorld articles to friends! This button is located in the top right corner of any article view.

The AccessWorld app team hopes you enjoy this new version of the AccessWorld app, and we appreciate all of the great feedback you have given us. We are always looking for new ideas to improve the app, so keep the letters coming.

Stay tuned for more updates, and keep an eye out in coming months for even more app development from AFB and FloCo Apps.

Lee Huffman

AccessWorld Editor-in-Chief

Washington, DC-On Tuesday, February 7, Senator Tom Harkin (D-Iowa) convened a hearing to examine access to education through the deployment of accessible technology.

Harkin chairs the U.S. Senate Committee on Health, Education, Labor and Pensions, which convened the hearing entitled "The Promise of Accessible Technology: Challenges and Opportunities." It focused strongly on the importance of accessible technology and how the issue impacts K-12 and higher education.

Witnesses who spoke at the hearing included: Eve Hill, Senior Counselor to the Assistant Attorney General, Civil Rights Division, Department of Justice; Mark Riccobono, Executive Director, Jernigan Institute, National Federation of the Blind; Dr. John B. Quick, Superintendent, Bartholomew Consolidated School Corporation in Columbus, Indiana; and Mark Turner, Director, Center for Accessible Media, Accessible Technology Initiative, California State University (CSU).

The hearing was broadcasted live online at www.help.senate.gov. Real-time captioning and sign language interpreters were provided.

In her opening comments, Eve Hill acknowledged:

"We are at a critical juncture for people with disabilities and technology. As we come to realize anew each day, the pace of technological change is amazing; what appeared impossible just years or even months ago is now commonplace. Advancing technology can open doors for many people with disabilities and can provide the means for them to move closer to the goal of full, equal, and truly integrated access to American life. But cutting-edge technological advances will leave people with disabilities behind if the entities that develop, manufacture, and offer technology do not make their products and services accessible."

In her testimony, Hill discussed how enforcement of these laws by the Department of Justice has resulted in public entities, public accommodations, and some technology developers and manufacturers taking new approaches to technology accessibility. She noted how the Department of Justice's work, along with that of the Department of Education, is making a difference in education for students with disabilities. Hill's testimony at the hearing also addressed the importance of internet access for people with disabilities in the education context and beyond, and discussed the Department of Justice's rulemaking activities on the accessibility of information on the web, as well as rulemaking activities of the Access Board, the Department of Transportation, and the Federal Communications Commission. She also spoke of how the Department of Justice's enforcement efforts are helping to ensure that other types of technology enhancements continue to improve the lives of people with disabilities across a variety of activities, as Congress intended in enacting the ADA.

Also providing testimony at Tuesday's hearing was Executive Director, Jernigan Institute, National Federation of the Blind, Mark Ricobono. During his testimony, he called for a new paradigm of accessibility, one in which there is mainstream accessibility from the beginning instead of being retrofitted to make accommodations. He stated, "There are two central elements to making education accessible to all students. The first is access to educational facilities....The second is access to information."

At the hearing, his recommendations for federal policy included:

• Stronger oversight and accountability in government
• Strong, functional, and rigorously enforced standards
• Projects to collect, develop, and disseminate best practice tools
• Improved protections against inaccessible technology in education
• Deepening awareness and expertise among IT professionals; and
• Strengthening nondiscrimination protections under the law

Third to provide testimony at the hearing was Dr. John Quick, Superintendent of the Bartholomew Consolidated School Corporation (BCSC). He provided an overview of the school system's implementation of a Universal Design for Learning (UDL) program and its use of accessible technology to improve the learning of all its students.

He described the diverse student population in the school system and how it worked to address the student's learning needs. In 2008, the school system made a decision to use UDL across all its programs as the framework to design all instruction and curriculum in the district. The school system found this framework has helped uphold the expectation that all learners will achieve to their highest level. He also discussed how using UDL has advanced the school system's educational outcomes.

Quick described how UDL serves as a framework to make learning environments accessible to all students. He also detailed UDL's three overarching principles: engagement, representation, and action/expression and how they create an accessible learning environment.

Quick states that because the BCSC population is diverse, it recognizes the need to create flexible learning environments which are standards-based and use accessible technology when appropriate. BCSC's teachers use the framework of UDL as a decision-making tool to help them determine what strategies, accessible technologies, and methods they will use to help students achieve the goals of the lesson. During his testimony, he described how having the appropriate technology for a student helped curb behavior problems and facilitated learning.

Also providing testimony at Tuesday's hearing was Mark Turner, Director of the Center for Accessible Media at California State University (CSU). His remarks focused on the issues faced by postsecondary institutions as they work to ensure that technology used to deliver educational programs and services are usable by all students, staff, faculty, and members of the public regardless of disability.

Turner discussed CSU's commitment to excellence, its commitment to equal opportunity, and the diversity of CSU's disability community. He also detailed how technology is fundamentally changing the educational landscape, while making the argument that Educational technology adoptions can either improve or worsen accessibility issues for students as well as institutions.

The CSU system is a model of accessibility, not only in providing accommodations for students with disabilities, but because CSU officials work to ensure that underlying technologies and systems are accessible. Turner also spoke about CSU's successful efforts to work with Apple to transform its iTunes U into an accessible offering and the challenges yet to be met in convincing Google to fully address access to Google Apps. He also made clear that CSU's job would be easier if federal (and state) governments would live up to their obligations to purchase and use technologies that are accessible to people with disabilities. Section 508 is a federal law that requires this, but as Turner noted, governments don't require technology vendors to validate their claims regarding accessibility and no performance testing is done.

Turner stated that CSU campuses commonly hear from technology vendors that other customers including Federal and State government entities across the country are adopting products despite the presence of accessibility barriers, suggesting that Section 508 implementation is insufficient to drive market changes.

Turner went on to suggest federal entities be charged with ensuring that Section 508 procedures are revised to more adequately address accessibility including:

• Validating product accessibility documentation;
• Conducting conformance testing prior to adopting high-impact products; and
• Sharing test results with other government and education entities to reduce redundant efforts.

Through Turner's testimony, CSU also asked that Congress require recipients of Federal grant funds to ensure that technology products developed as components of these grants conform to Section 508 standards and urged the Department of Justice to send a "Dear Colleague" letter to the 100 largest IT vendors, reminding them of the importance of ensuring that their products are accessible to people with disabilities.

Finally, CSU also strongly supported the recommendations from the AIM Commission report18 including revising the scope, effectiveness, and function of the Copyright Act as amended (Section 121, the Chafee Amendment) to broaden the definition of individuals eligible for specialized formats, and authorizing the United States Access Board to establish guidelines for accessible Instructional Materials that will be used by government, the private sector, and postsecondary institutions.

Redbox Discriminates Against the Blind by Failing to Provide Accessible Self-Service Kiosks

Recent technological advances are sweeping the nation, changing the way people buy products and services. Self-service kiosks with automated, touch-screen interfaces now allow people to bank, shop, and conduct a wide range of transactions independently, without the assistance of a clerk. This technology is fast becoming an integral part of our every day lives.

Although these technologies can make our lives easier, Redbox, a video rental giant, has chosen to use self-service kiosks with touch-screen controls that exclude the blind from using its services. Blind Californians cannot use touch-screen kiosks that offer only visually-based controls. A class action lawsuit filed in the United States District Court for the Northern District of California challenges Redbox's inaccessible kiosks. The lawsuit is the first of its kind in the country.

The suit is brought by the Lighthouse for the Blind and Visually Impaired, as well as five blind individuals, on behalf of blind and visually impaired people throughout California. Plaintiffs are represented by Disability Rights Advocates (DRA), a non-profit disability rights legal center headquartered in Berkeley, California, that specializes in high-impact cases on behalf of people with disabilities. Plaintiffs are also represented by the Law Offices of Jay Koslofsky.

Redbox has a major share of the video rental market. Redbox DVD rentals account for approximately 34 percent of the DVD rental market nationwide. According to Redbox, almost 60 million videos are rented from its kiosks nationally each month. Redbox kiosks can be found at thousands of businesses throughout California including Save Mart, which is a business that is also named as a defendant in the lawsuit.

For generations, blind and visually impaired people have watched and enjoyed movies as an ordinary part of daily life. Blind people with some remaining vision may watch films on their own or with sighted friends and family who can describe the details and actions of a film. In addition, many blind people enjoy watching dialogue-driven films.

Redbox's inaccessible touch-screen kiosks shut out a large and growing community of blind Californians. It is estimated that 100,000 Californians are legally blind and as the population continues to age, the number of adults with vision loss will increase.

The technology exists to make self-service kiosks accessible to the blind. Accessible ATMs and iPhones make use of tactile controls and/or screen reading software that enables blind people to use these devices.

"A lack of accessibility in newly emerging forms of commerce is a symptom of the overall growing technological divide that blind people experience when companies fail to build in accessible features at the onset," said Bryan Bashin, Executive Director/CEO of the Lighthouse for the Blind and Visually Impaired.

"Technology is a double-edged sword. It has the power to enable millions, but it can disable many Americans far more than it enables them if accessibility is not built into technology at the beginning," said Jay Koslofsky, Plaintiffs' attorney of the Law Offices of Jay Koslofsky.

"Redbox is shutting out thousands of Californians from its services because it refuses to make its technology accessible to blind consumers," said Michael Nunez, Plaintiffs' attorney of Disability Rights Advocates.

American Foundation for the Blind Scholarship Program 2012

American Foundation for the Blind (AFB) administers seven post-secondary education scholarships for up to 11 deserving students who are legally blind:

Delta Gamma Memorial Scholarship—One scholarship of $1,000
    •Undergraduate or graduate study in the field(s) of rehabilitation and/or education of people who are blind or visually impaired.

Ferdinand Torres Scholarship—One scholarship of $3,500
    •Undergraduate or graduate study in any full-time program in any field.
    •Applicants need not be US citizens, but must reside in the US. Preference given to New York City metropolitan area residents, and new immigrants to the US.

Gladys C. Anderson Memorial Scholarship—One scholarship of $1,000
    •Undergraduate or graduate study in classical or religious music.
    •Applicants must be female.

Karen D. Carsel Memorial Scholarship—One scholarship of $500
    •Graduate study in any full-time program in any field.
    •Applicants must submit evidence of economic need.

Paul W. Ruckes Scholarship—One scholarship of $1,000
    •Undergraduate or graduate study in engineering or in the computer, physical, or life sciences.

R. L. Gillette Scholarship—Two scholarships of $1,000 each
    •Undergraduate study in a four-year degree program in literature or music.
    •Applicants must be female.

Rudolph Dillman Memorial Scholarship—Four scholarships of $2,500 each
    •Undergraduate or graduate study in the field of rehabilitation and/or education of people who are blind or visually impaired.

Visit the AFB scholarships website for further information and to fill out the application.

Please direct questions and comments to: American Foundation for the Blind Information Center, (800) 232-5463, afbinfo@afb.net

The National Federation of the Blind Offers 30 National Scholarships

To recognize achievement by blind scholars, the National Federation of the Blind (NFB) annually offers blind college students in the United States the opportunity to win one of 30 national scholarships worth from $3,000 to $12,000. See the NFB scholarship website for the rules on eligibility, requirements for documentation, and an online application form. Membership in the NFB is not required. The 2012 NFB Scholarship Program begins November 1, 2011. Application deadline: March 31, 2012.

The White House Disability Group Resumes Monthly Disability Calls

These monthly calls are hosted to update interested parties on various disability issues as well as to introduce people who work on disability issues in the Federal government.

These calls are open to everyone. If you would like to be added to the e-mail distribution list, please visit the White House Disability Group website and fill out the contact us form in the disabilities section. Alternatively you can send your full name, city, state, and organization via e-mail to disability@who.eop.gov.

Nokia Symbian Belle Accessibility News from Code Factory

When Nokia announced its latest version of Symbian operating system, Symbian Belle, with new UI updates and performance improvements, Code Factory aimed to make this operating system accessible for all its users. Symbian Belle is currently available in three phones, the Nokia 700, 701 and 603, with more supported phones to come.

Belle features resizable widgets and many enhancements to the UI. The new Belle devices are the first Symbian phones to feature a 1GHz processor which provides notable speed improvements. Comprehensive accessibility support, similar to what is provided on Symbian^3 and Symbian Anna devices, is given by Mobile Speak v5.7. This includes support for e-mail, Web browser, Ovi Maps v3.04, Nokia Internet Radio, Standby Screen shortcuts, and more. Current Symbian^3 and Symbian Anna devices (N8, E7, C7, C6-01, E6, X7 and Nokia 500) will receive a firmware update to Belle early in the 2012.

Note that since previous versions of Mobile Speak are not compatible with Symbian Belle, these users must first update to v5.7 of Mobile Speak prior to updating their phone's firmware to Belle.

Major features:

• New gestures: In order to access the new left-center and right-center buttons present in many Belle applications, new triple-slide gestures have been introduced: slide left-right-left for the left-center button and slide right-left-right for the right-center button. These gestures are available in applications like Messaging, to allow quick access to some specific app features. Two new gestures have been introduced to organize the main menu elements: slide up-down-up (which is also available on the home screen) and slide down-up-down.
• Improvements to Mobile Speak commands: Commands of Mobile Speak are now divided in four groups to make it more logical and less time consuming to use.
• New Switch Commands setting.
• Touch: New configurable vibration feedback when performing taps in Keypad mode for easier learning for beginners.
• Braille: built-in support for HIMS Braille Sense devices.
• New supported devices: Nokia C5 5MP (Symbian 9.3), Nokia 500 (Symbian Anna), Nokia 603, 700 and 701 (Symbian Belle).
• Many bug fixes, including a fix to the issue where the Web browser was activating links unexpectedly on some devices.

To check the whole list of various improvements and bug fixes, please consult Sections 2.1 and 2.10 of the Code Factory Symbian user guide.

To read more about Mobile Speak visit the Code Factory Mobile Speak page.

You can download Mobile Speak 5.7 and try it free for 30 days. Note that only the Acapela German Julia and Catalan Laia TTS installation packages have changed since v5.6. No other TTS installation files have changed, so there is no need to reinstall them.

Free Eye Exams for Service Animals

Thousands of service animals across the United States, Canada, and Puerto Rico will receive free eye examinations in May 2012, thanks to the 5th Annual ACVO/Merial National Service Dog Eye Exam Event. With the help of volunteer board-certified veterinary ophthalmologists, life-saving eye exams are performed so that these animals can continue to do their important jobs.

Since the program launched in 2008, more than 10,500 service animals have been examined. In addition to dogs, other service animals including horses and even a service donkey received free sight saving exams.

To qualify, animals must be "active working animals" that were certified by a formal training program or organization or are currently enrolled in a formal training program. The certifying organization could be national, regional, or local. Owners/agents for the animal(s) must FIRST register the animal via an online registration form beginning April 1, 2012; registration ends April 30th. Once registered online, the owner/agent will receive a registration number and will be allowed access to a list of participating ophthalmologists in their area and may contact a specialist to schedule an appointment. Appointments will take place during the month of May. Times may vary depending on the facility, and are filled on a first-come, first-served basis.

Accessibility Forum at CSUN 2012

Title: "Taking Accessibility Mainstream — Making the Case for an International Society of Accessibility Professionals"

Date: Tuesday, Feb 28, 2012

Length: One day

Time: 8:30 AM – 4:45 PM

Location: 2012 CSUN Conference, Manchester Grand Hyatt Hotel, San Diego, CA
Edward Room, 2nd floor
(Registration for this event is separate from the CSUN registration. See below for registration details.)

Hosted by: Accessibility Interoperability Alliance (AIA) — the technical & engineering division of the Assistive Technology Industry Association (ATIA)

Overview: This forum is intended to bring focus to the needs of the development community in achieving accessible technology.

As evidenced by the results of the Developer's Survey on Accessibility conducted in late 2010, respondents highlighted an industry and profession in the midst of a fragmented landscape of partial solutions and serious obstacles to the attainment of more uniform, universally accessible technology. These obstacles range from basic challenges, such as a lack of developer skills, little or no coverage in engineering courseware, and lack of testing/development tools, to more subtle issues that include a poorly understood business case and lack of a cohesive professional identity for accessibility developers.

The objective of this Forum is to allow for sharing of insights and best practices, discussion of critical issues facing the industry, and advancement of the concept of an International Accessibility Professional Society with an infrastructure to support it. The goal is for those within the business and development communities to be the driving force for change in the accessible technology environment.

Schedule and Session Details — For additional details including Schedule-at-a-Glance and session descriptions.

Pricing: Regular Registration — $295 per person — Registration Fee starting 2/1/2012

Registration for this event is a separate fee from the CSUN Conference and utilizes a separate registration form.

To Register:Online Registration FormRegistration is now open!!

Request for More Information — Fill out this form to be added to the distribution list for the Accessibility Forum. You will be notified as additional details become available.

Who should attend?

All individuals worldwide currently focused on advancing accessibility within their organization or with a need to begin an accessibility implementation within their organizations. We encourage organizations to bring teams to this event. Attendees will include Accessibility Officers/ Program Managers and all those involved in the IT development lifecycle, including Product Managers, Programmers, Web Developers, Information Architects, Designers and Testers.

Organizations who could benefit from attending include those within electronic/information technology (E/IT), assistive technology (AT), higher education, and accessibility organizations plus all organizations who require accessible systems to support their employees and their customers such as financial services, healthcare, manufacturing, retail, hospitality, and many others.

Dear AccessWorld Editor,

HumanWare would like to thank AccessWorld for evaluating Trekker Breeze and for letting more users know about our products. Acquiring a GPS signal can depend on the frequency of use. With daily use, satellite acquisition is often less than one minute. As in all GPS devices, a constant walking speed is necessary to obtain a reliable heading. As the author mentions, the Trekker Breeze strengths are the ease of use and its capability to be used in a car, as a pedestrian walking on streets and open areas such as parks and campuses.

Lucia Gomez, Product Manager

One day last fall I received a letter that captured my attention—and my imagination. A Canadian reader named Debbie Gleeson who had seen my product review of the Seika refreshable braille display wrote with a question regarding the product. She was installing the unit on a laptop, she said, that she planned to deliver to a blind couple in Rwanda.

Answering her question began a dialogue that has provided me with a vicarious look at life in post-genocide Rwanda: what it's like to live there, visit there, and be a person who is blind there.

Gleeson and her husband Phil ran a small insurance brokerage firm in southern Ontario for many years. With her children grown and retirement a reality, Gleeson began entertaining a wish she had held for years, a wish of helping people in a disadvantaged country. In January of 2009, Gleeson saw a television documentary about a woman from Quebec, Nicole Pageau, who ran a center for orphans and widows in Rwanda. An e-mail correspondence began, and Gleeson's first sojourn to this African country was launched. Since then, Gleeson has made two journeys a year to Rwanda. Her trips are filled with days of teaching and giving in myriad ways to the children and adults left in the wake of the genocide. She brings sewing machines and teaches women to sew school uniforms for children and simple garments to generate desperately needed income; she passes out shoes to street orphans. Along the way she has developed an amazing friendship with Pierre and Vanantie, the blind couple for whom she and her husband purchased the laptop and braille display.

Gleeson met Pierre on her first visit to Rwanda. A trained massage therapist, he is employed by Pageau's center. He and Vanantie were the first blind couple to be married in Rwanda, where according to Debbie, people who are blind are typically unskilled, abandoned, and/or illiterate. There are no schools for the blind, and no government programs to provide training to blind children or adults. Vanantie, who graduated from university in December, received an education by way of an experiment by the government, wherein her studies were sponsored and the university provided access to a computer and sighted classmates to help her.

Debbie Gleeson is not blind and she has no specific training in blindness. She is, however, a skilled computer trainer (software training is another of the many gifts she has given during her Rwandan visits), and when she learned that Vanantie would lose her newfound access to technology upon graduation, she was moved to acquire the laptop and braille display. (A blind friend in Gleeson's hometown of Elmira pointed her in the direction of the Seika as a low-cost display.)

Pierre and Vanantie, Gleeson reports, are rapidly becoming advocates for people with disabilities in their region—they locate them, and provide them with information and encouragement as they are able. The couple has two small children, and they feel blessed to live in a house rented to them by the government. They give what they can to others, having taken into their little home a young blind woman named Emily who had lived alone in her hut of palm leaves and tin, afraid to venture out, waiting for others to bring her food. Now, living with Pierre and Vanantie, Emily is also learning to read braille and gaining self-confidence.

"Pierre is an incredible organizer," Debbie says, citing as an example the delivery of the 150 collapsible white canes she took with her on her last visit to Rwanda. To distribute the canes, she and Pierre secured a cargo van of sorts and then drove to each of the various villages where he had located blind people.

When Gleeson tells Vanantie and Pierre about her blind friend in Elmira, a man who is employed, has a family, a guide dog, and advanced computer skills, they are amazed. With each trip, she brings more information and what limited supplies her three suitcases can hold. Having a job at all is a rarity, whether one is blind or sighted. On Gleeson's most recent visit, Pierre's massage work had diminished from three appointments per week to one, and Vanantie has not yet found employment.

All utilities in Rwanda are pay-as-you-go, Debbie explained to me, in the way that prepaid cell phones are in the United States and Canada. On each visit, Debbie purchases electricity, charcoal for heat, Internet service, and cell phone minutes for Vanantie and Pierre as well as others. There are no land-line phones, so all communication is done by cell phone, typically text messaging.

Each time Gleeson travels, she is permitted to carry three suitcases into the country. With such space limitations, she is sometimes more confined by the luggage restrictions than by the generosity of others who donate to the cause. Still, she manages each trip to take shoes, sewing machines and, last fall, the 150 white canes.

Gleeson speaks with awe of the many wonderful people she has met in the course of her self-appointed work in Rwanda, and with equal awe of the poverty and pain mixed with hard work and optimism she has witnessed there. The sewing machines she donated, for example, were electric, and electricity must be purchased in increments and is expensive. Parts are also expensive. One light bulb on a sewing machine cost about 1,000 francs, the equivalent of $2 Canadian, an amount that a Rwandan could use to buy food for a couple of days.

Her husband, who still works in their company part-time, will be traveling with her for the first time on their next trip in January 2012. Together, she said, the couple will be engaged in building either a house or a school. As usual, Gleeson will also be teaching women to sew, purchasing electricity and internet service for as many as she can, and delivering more blindness-related tools and information to Pierre and Vanantie. Sadly, she was informed on her last visit that the suitcase maximum will be reduced to two, further limiting the amount of supplies she is able to carry.

Serious health issues in her own family may well mean that Gleeson will make only one Rwanda trip in 2012, but this inspiring woman is by no means finished with her devotion to enhancing the quality of life for people with and without disabilities, in this country filled with so many challenges.

"We have been very blessed," she says simply of her husband and herself. "We are not wealthy, but we are able financially to make these trips and purchase [the goods and services] as we have."

In addition to providing software training and sewing lessons, distributing white canes and providing one blind couple with assistive technology, constructing homes or schools and sponsoring children to attend elementary school, Gleeson is carrying information and plenty of hope to people who are hungry for more than just food.

To read more about her ongoing work in Rwanda, visit Debbie Gleeson's blog.

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People with vision loss want, and increasingly expect, to experience a museum or park as fully as a person with normal vision. Museums and parks have made great strides in accessibility for patrons who are blind or visually impaired. The use of audio descriptions, GPS devices, and other accessible technologies, along with exhibit design improvements and better information sharing among cultural and educational institutions, have made these resources increasingly enjoyable and accessible to visitors with vision loss.

Organizations Dedicated to Improving Access to Cultural Institutions

Art Education for the Blind & Art Beyond Sight

Art Education for the Blind (AEB) and its website, Art Beyond Sight, provide materials specific to accessibility strategies and standards for art museums. AEB has made it its business to work on improving access to the arts in the US and abroad for people who are blind or visually impaired. It promotes national and regional programs through exhibitions, granted projects, and more. AEB worked with the AFB Press division to create the textbook Art Education for the Blind and Art Beyond Sight, a resource for teachers, rehabilitation professionals, and those interested in art education for people with vision loss. The book contains extensive information, techniques, strategies, and approaches.

Consumer Groups

Both the American Council of the Blind (ACB) and the National Federation of the Blind (NFB) have interest groups specific to the arts. Both organizations have worked with museums to promote access in accordance with the Americans with Disabilities Act.

Accessibility Devices and Strategies Currently in Use in Cultural Institutions

A variety of devices are used in museums and parks today to increase access for blind and visually impaired patrons. Though no single strategy will answer the accessibility needs for every institution or exhibit, many of these devices provide great improvements to access.

Durateq from Softeq

The Durateq is a top-of-the-line audio description device suitable for use in parks and museums. The Durateq uses GPS for providing access to outdoor points of interest. Indoors, it uses small beacon-type markers to trigger descriptions of exhibits or objects.

guidePORT System from Sennheiser

The guidePORT is a handheld device that offers a variety of programming options to provide more- or less-detailed tours depending on visitor preference. The device can provide a wide variety of language programming for institutions with international or multi-lingual visitorships.

Tourmate System

The Tourmate is an older device still in use in many museums. It uses recorded descriptions associated with specific objects or exhibit identification numbers. To hear a description, the user enters the identification number (found either through braille or the assistance of a sighted helper) into the device via a keypad. The Tourmate is not as flexible or convenient as an automatically triggered device.

Push-Button Audio Boxes

A common and often-preferred method for delivering audio description, the push-button audio box system provides all patrons the same method of access to information about an exhibit. The boxes can be designed to be weatherproof as well, allowing for indoor or outdoor use.

Tactile Representations

When it comes to objects such as sculpture, silver collections, and glass collections, nothing beats making a portion of the exhibit available for tactile exploration with guidance from museum staff. Of course museums can't make priceless or delicate works or objects available to the public for handling, but providing representative pieces or reproductions appropriate for tactile exploration is an incredible improvement to accessibility and vastly enriches the experience of the patron with vision loss or blindness.

Accessibility Suggestions for Museums and Parks from People with Vision Loss

1. Braille signage should be formatted correctly and placed in appropriate, easily discoverable locations.
2. Audio descriptions, large print, and braille should provide the same information as the standard print formats.
3. To better accommodate people with low vision, signs describing artwork or exhibits should be large and use large sans-serif fonts with highly contrasting colors.
4. Audio-described tours using portable access devices should provide navigation that allows the patron to skip around when listening to descriptions.
5. Museum and park staff should be trained to effectively interact and communicate with people with disabilities, including those with vision loss, and should be trained in the access devices at use in their institutions.
6. Visual displays and electronic signage should use large fonts in highly contrasting color schemes.
7. Objects such as sculptures should be placed in front of high-contrast backgrounds to make them easier to see.
8. Lighting should be designed to reduce glare on exhibits and works of art.
9. Museums should provide access through senses beyond sight. Some museums have representations in a smaller tactile version to allow patrons to feel the shapes and design in specific paintings.

Recommended Cultural Institutions for Visitors who are Blind or Visually Impaired

The Huntington Museum of Art

The Huntington Museum of Art in Huntington, West Virginia, is an example of a smaller museum making strides to provide accessibility to people who are blind or visually impaired. The museum has made a number of efforts to enrich the experience of patrons with vision loss or blindness, including adapted pottery classes, audio tours, specialized training in audio description for docents, a sensory trail surrounding the museum. The museum embraces the visually impaired community, sets a high accessibility standard for small museums across the nation, and continues to work on additional strategies to provide more accessibility.

Disney Theme Parks

Walt Disney World Hotels and Resorts have made accessibility a priority for a number of years. Well-known for impressive customer service, Disney is committed to serving people with disabilities, including those who are blind or visually impaired. In 2011, AFB presented Disney with an Access Award for instituting the use of the Durateq device at Disneyland in California.

National Park Service

The National Park Service (NPS) has embraced new technologies to provide more accessibility for exhibits and tours. The African Burial Ground site in Manhattan features an accessible tour with audio description that provides access to multiple forms of media including video and print. The NPS is currently investigating access to images from parks and exhibits via the Web, a strategy that would provide more viewing options to people with low vision.

Additional Highly Recommended Museums

The New Britain Museum of American Art—New Britain, Connecticut

The Ringling Museum of Art—Sarasota, Florida

The Boston Museum of Fine Art—Boston, Massachusetts

The Metropolitan Museum of Art—New York, New York

The Museum of Natural History—New York, New York

The Intrepid (Naval aircraft carrier ship /museum)— New York, New York

African Burial Ground National Monument—New York, New York

Hamilton Grange National Memorial—New York, New York

North Carolina Aquarium at Pine Knoll Shores—Moorhead City, North Carolina

The Dallas Museum of Art—Dallas, Texas

The Smithsonian Institution, the Castle—Washington, DC

The International Spy Museum — Washington, DC

What's Ahead in Audio Description

To get a sense of the common challenges for deploying audio descriptions in cultural institutions, I spoke with William Patterson, head of Audio Description Solutions (ADS), who has a long career in audio description and has provided training in this area since the 1980s. ADS set the original standards for audio description and continues its work today. Patterson is a founding member of the Audio Description Coalition, a national organization dedicated to maintaining the highest quality audio description through training, mentoring, evaluation, and professional development.

ADS currently contracts with museums, parks, and other cultural institutions to help them provide better audio description options to the public. According to Patterson, the most important aspect of a successful audio description program is for "organizations…to think about accessibility before they design and implement their exhibit."

Patterson has helped museums and parks nationwide provide descriptive access to their collections and exhibits. He has extensive experience with many different audio description devices, including the Durateq device currently used by Disney and many other organizations. When it comes to the best practices for installing these types of devices, Patterson offers the following advice: "The placement of beacons or transmitters is important because you don't want to restrict access in areas with a crowd.… [Poor] placement of a beacon could cause a person to hear the description for one exhibit while standing in front of another. This is not an uncommon experience."

In addition to providing guidance on the physical implementation of devices and their supporting equipment, Patterson works with organizations on the nature of the information contained on these devices. He stresses the balance between offering enough information so users have a rich and complete experience, without overwhelming them with an overabundance of detail or history. Patterson also stresses the importance of using language that most people will understand easily.

Visit Audio Description Solutions for more information about their services.

Conclusion

While much work has been done to improve accessibility in cultural institutions, there is still more to do to ensure people with vision loss can participate equally. I hope this report inspires you to get involved with your local museums and parks—get out there and experience the world!

The authors would like to acknowledge the contributions of Sheila Amato to this article.

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In a September 2011 AccessWorld article, I raised concerns about a number of significant trends altering the design and use of information and communication technology. These interdependent trends include: the dramatic increase in mobile information technology and associated apps, the emergence of cloud computing, and the rapid rise of social network-driven communication. To these trends, I would also add the rise of virtual reality and gaming technologies in the classroom and workplace. On balance, these developments are leading to technologies that are decentralized, personalized, and rapidly changing, all qualities that disrupt traditional accessibility mechanisms—such as assistive technologies and adaptation strategies—for people with vision loss. On the other hand, because this new technology environment is more open to rapid innovation and targeted solutions, the potential rewards are tremendous, especially if accessibility can be built into the technology at no extra cost to the consumer, as Apple has done, by providing comprehensive, built-in accessibility in their products.

How can we work to ensure comprehensive and effective access for people with vision loss in this new environment? Can the increasing desire and expectation among consumers with vision loss for technologies with built-in accessibility be met? What role can assistive technology (AT) play in ensuring comprehensive accessibility, particularly as AT-based solutions are too often incomplete and playing catch-up to developments in mainstream technology? Most important, how do we ensure access to the technologies used at work and in school?

To ensure access in this new and emerging environment, advocates and technology developers must explore multiple and perhaps novel strategies. This month, I will focus on fostering accessibility through public policy and other targeted government action. In an upcoming article, I'll look at additional methods that address accessibility, such as cultivating corporate social responsibility, the value of doing good, leveraging critical, broad-based trends such as inter-operability and privacy, and international accessibility standards with broad stakeholder buy-in. Finally, I plan to look, in detail, at the pros and cons of built-in accessibility by major technology developers, especially Microsoft and Google. I also invite those of you attending the 2012 CSUN Technology and Persons with Disabilities Conference to attend the session entitled Fostering Built-in Accessibility, where this topic will be further discussed.

Using Legislation and Regulation to Stimulate Technology Accessibility

Over the past 20 years, advocates for people with disabilities have successfully pushed for legislation to foster accessibility in the design and development of information and communication technologies. In the United States, these policies have emphasized both direct requirements for accessibility placed on commercial developers of technology and market incentives to support accessible technology. For example, the recently enacted Communications and Video Accessibility Act (CVAA) requires developers of a range of communications and video technologies to incorporate accessibility for consumers with disabilities. The CVAA was modeled on the groundbreaking policy set forth in Section 255 of the Communications Act (discussed below), which required telecommunications technology be accessible to, and usable by, people with disabilities. Another law, Section 508 of the Rehabilitation Act, attempts to support accessibility by requiring US government agencies to purchase technologies that are accessible for people with disabilities. Finally, the Americans with Disabilities Act (ADA) established that individuals with disabilities have a right to accommodations in the workplace including accessible technology along with access to goods and services in the community including access to websites.

These and other hard-fought policies continue to evolve as advocates work to keep up with changes in technology and to strengthen enforcement. Legislation like the CVAA and Section 508 is critical, because these policies establish the expectation and framework for nondiscrimination and accessibility. However, legislation alone, as I will further explain, is not enough to ensure technology accessibility. Far too often, policies are not effectively or comprehensively enforced. Individuals must take action to assert the rights and opportunities afforded by legislation. In short, consumers with disabilities must file complaints and demand full accessibility. There are other problems inherent in the policy process. For example, legislation takes a long time to enact, and the process requires compromises that water down the clear requirements initially sought by advocates, and stretch timeframes for implementation. More compromises are made during the regulatory process as government agencies craft regulations to implement the legislation and determine how to enforce it. In sum, the experience with US policies that address accessibility shows that legislation is absolutely essential, but its effectiveness is limited by ambiguous language, broad exemptions, narrow focus, poor enforcement, and a slow implementation process that makes it difficult to keep up with changing technologies.

Stimulating Technology Access Using Section 508

We have reported on an accessibility law known as Section 508 in previous issues of AccessWorld. Section 508 refers to a provision included in the Rehabilitation Act that requires the US government to ensure that the information and communication technology purchased, developed, maintained, or used by federal agencies is accessible to individuals with disabilities, unless it would be an undue burden or require a fundamental alteration to do so. In short, the use of technology by people with disabilities, whether government employees or members of the public, should be comparable to non-disabled persons. Section 508 was first enacted in 1986, but the lack of clear requirements and enforcement meant that it languished in obscurity until the legislation was strengthened in 1998.

The idea behind Section 508 was to develop a market-based strategy to foster the design of accessible technology. Because the federal government is a huge purchaser of information and communication technology, Section 508 would, in theory, take advantage of the power of US government spending on products and services. The impact would be further magnified, because many state governments also base accessibility requirements on Section 508. Disability advocates hoped that the technology industry would compete to improve accessibility, either through innovation to gain an edge in competitions for government procurement or out of fear of losing lucrative government contracts. In addition, advocates also hoped that companies might use Section 508 to challenge the award of a government contract for a competitor's inaccessible technology.

In practice, government agencies haven't aggressively pushed accessibility by demanding proof of accessibility in technology equipment and services and because loopholes in the law make it too easy for agencies to disregard the access obligations. For example, an agency can argue that no commercially available accessible device or software meets the need, or it could find that changes that might be needed to bring about accessibility would fundamentally alter the technology's functionality.

Section 508 authorizes individuals to file administrative complaints regarding inaccessible information and communications technologies against the agency that purchased the inaccessible technology. The statute requires federal agencies to process Section 508 complaints according to the same complaint procedures used to process Section 504 program access complaints. Unfortunately, it appears that relatively few individuals have brought complaints, perhaps because employees fear retaliation. Individuals can file complaints with a federal agency's civil rights office, and federal employees can file employment-related complaints with the Equal Employment Opportunity Commission.

Although Section 508 has not necessarily resulted in significantly improved accessibility, the law has led to the development of a comprehensive set of criteria establishing detailed accessibility requirements across a variety of technology products and services. The Access Board, a small, independent US government agency, is responsible for defining accessibility for information and communication technology. The Access Board is currently in the process of rewriting the accessibility rulebook and in December, 2011, it issued a second Advance Notice of Proposed Rulemaking (ANPRM) to continue the process of updating accessibility standards for information and communication technology. Individuals are encouraged to comment on all aspects of this notice by March 7, 2012. The update is most assuredly needed as the current accessibility rules were approved in 2000. A good resource for further information about Section 508 can be found at www.section508.gov.

Using the ADA to Address Technology Accessibility

The Americans with Disabilities Act (ADA) did not directly address access to information and communication technology products or services except for the establishment of a telephone relay system for people with deafness or speech disabilities. The law generally focuses on ensuring that individuals are protected from discrimination in employment or in the access to businesses and services. Because Title III of the ADA prohibits discrimination in access by people with disabilities to the goods and services of any place of public accommodation, advocates have successfully argued that technology like automatic teller machines are required to be accessible under ADA. Although neither the statutory language of the ADA, nor the accompanying regulations, specifically addressed access to the Internet or the Web, the United States Justice Department has consistently stated that the ADA applies to websites of private entities that meet the definition of 'public accommodations. Summarizing the situation in 2010, the Justice Department stated, "inconsistent court decisions, differing standards for determining Web accessibility, and repeated calls for Department action indicate remaining uncertainty regarding the applicability of the ADA to websites of entities covered by Title III." Accordingly, the Justice Department has indicated that it plans to publish a proposed regulation providing detailed guidance on website accessibility by December 2012.

Section 255 Sets Groundbreaking Requirements for Telephone Access

The enactment of Section 255, a law requiring telephones and telephone service to be designed to be accessible to people with disabilities, was a landmark achievement in access policy. The law was added to the Communications Act in 1996, and requires manufacturers of telecommunications equipment and providers of telecommunications service to ensure that their products and services are accessible to, and usable by, people with disabilities, if it is readily achievable to do so.

Section 255 is limited to access that directly relates to communication via telephone. This means that many features now commonly found in cell phones, such as Web browsing and e-mail, are not required to be accessible, even though the telephone calling features of the same devices are. Whether or not Section 255 applies to text messaging was never fully resolved, but the new CVAA does cover text messaging along with other advanced communication features such as e-mail and Web browsing. Unfortunately, the telecommunications industry has been slow and inadequate in meeting their obligations under Section 255 by including access features into telephones (including cell phones), leaving consumers with vision loss with very few options for accessible products.

Under Section 255, consumers with disabilities can lodge a complaint against a company because of an inaccessible telephone or telephone service (either landline or mobile). If you would like to file a complaint, you can do so by contacting the Federal Communications Commission. Send details by mail to: Federal Communications Commission, Consumer and Governmental Affairs Bureau, 445 12th Street SW, Washington, DC 20554. You can also send a complaint via e-mail to the FCC at fccinfo@fcc.gov. Finally, you can also use a specific FCC web-based form to file a complaint. Although individuals have filed some complaints, action by the FCC has been relatively weak in enforcing access requirements.

What You Can Do

There are a number of policies now in place that address a variety of technologies and systems, including policies that require technology-based products and services to be designed so that they are fully accessible to individuals with disabilities. However, significant gaps remain. For example, there is no comprehensive requirement for accessibility of hardware and software commonly used in the workplace and increasingly used in educational settings. Advocates continue to work to improve policies and to strengthen their enforcement. While these policies are neither perfect nor comprehensive, consumers with vision loss or other disabilities can enhance the success of hard-won accessibility legislation by using the existing policies to file complaints about inaccessible products and services. It is critical to follow up on these complaints with demands for action by the enforcing agencies. Members of the public can file Section 508 complaints against government agencies that distribute documents or publish websites that are found to be inaccessible. Strong and decisive consumer action will, hopefully, convince the technology industry to respond by implementing, improving, and maintaining accessibility across their products and services.

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Because of the close relationship between diabetes and vision loss, we in the AFB Tech product evaluation lab periodically track the accessibility of the blood glucose meters used to help manage diabetes. Since our January 2008 AccessWorld article on the subject, the number of Americans with vision loss who have diabetes has risen from 3.2 million to 3.9 million. In the same time period, the number of accessible meters available on the US market has also increased; this article reports on the accessibility of those new meters.

In 2008, we reported that there were five meters available with speech output, but only one of those had comprehensive speech output that supported the independent use of all of the features available on the meter. This time around, we found 13 meters that had speech output, and four of those have comprehensive speech output supporting all features. This article focuses on those four meters:

• The Prodigy Voice from Prodigy Diabetes Care
• The Solo V2 from BioSense Medical Devices
• The Fora V20 from Fora Care, Inc
• The Fora V22 from Fora Care, Inc

Product Descriptions

Prodigy Voice

The Prodigy Voice ($40) originally came on the market in 2007, and has since been updated. The meter weighs 2.4 ounces and measures 2.2 by 4.0 by 0.8 inches. The front panel has a 1.2-inch by 1.5-inch monochrome black-on-gray display with three control buttons below and two directional buttons to the right. The round power button, also used to enter Memory Recall mode, is in the right-most position of the control buttons, has a raised "M," and is larger than the rest of the buttons. The triangular Settings button is the center control button and has a raised "S" on it. The Repeat button is the left control button and has a raised, left-pointing arrow on it. The Repeat button is used to repeat the last spoken message or test result. The speaker is located below the control buttons. The directional buttons located to the right of the display have raised up and down arrows and are used to select test results and change settings. The Prodigy Voice has a 3.5-millimeter headphone jack near the bottom right side panel of the meter, which allows you to connect headphones for privacy or a speaker for amplification. A mini-USB port below the headphone jack allows you to download the meter's test results to a computer using Prodigy's download software. There is also a slot on the bottom left side panel to attach a lanyard for easy carrying.

Fora V20

The Fora V20 from Fora Care, Inc. ($70) weighs 2.08 ounces and measures 3.69 by 2.25 by 0.78 inches. The front panel has a 1.2-inch by 1.5-inch monochrome black-on-gray display with three buttons below the display, two directional buttons to the right of the display, and a strip eject slider on the top right side panel. The Power button is the right-most control button and has a raised circle with an "M" in the center. This button can be used to turn the meter on and off and activate the Memory Recall mode. The Settings button is the middle of the three control buttons and has a raised square with an "S" in the center. The Recall button is the left-most control button and is used to repeat the last spoken message or test result. It has a raised arrow pointing to the left. The directional buttons are located to the right of the display and have raised arrows pointing up and down. The directional buttons are used to select different test results in the Memory Recall mode and to change settings. The speaker is located below the Repeat and Settings buttons. An eject slider, located on the top right side panel, ejects test strips when pushed up. A standard 3.5-millimeter headphone jack on the bottom left side panel allows you to connect headphones for privacy or a speaker for amplification. Below the headphone jack is a data port with a rubber cover that reads "PC" in raised letters. The data port is used with the Fora software to download test results to a computer. There is also a slot for a lanyard on the bottom right side panel.

Fora V22

The Fora V22 from Fora Care, Inc., ($80) weighs 1.76 ounces and measures 3.75 by 2.00 by 0.44 inches. The Fora V22 has a 1.2-inch by 1.6-inch circular screen with the strip eject slider to the left and the rest of the buttons below the display in a circular layout. In the center, the power button is recessed a little and labeled with a non-tactile "M." As with the previously discussed models, the power button on the V22 is also used to access Memory Recall mode in order to speak previous test results. To the right of the power button are the Repeat and Settings buttons. The Repeat button is located above the settings button and is used to repeat the last spoken message or test result and is labeled with a non-tactile arrow pointing to the left. The Settings button is located below the Repeat button and is labeled with a non-tactile "S." To the left of the power button are the directional buttons, labeled with non-tactile up and down arrows, which are used to select different test results and settings. The speaker is located directly below the power button. The Fora V22 features a built-in rechargeable battery. A recessed LED light centered on the right side of the front panel indicates the charging status of the meter. If the meter is plugged in and charging, the LED is red; if the meter is plugged in and finished charging, the LED is green. To the left of the display is a test-strip eject slider with raised bumps; push the slider up to eject a used test strip. On the bottom panel, there is a 3.5-millimeter headphone jack on the right that can be used with headphones for privacy or speakers for amplification. On the left side of the bottom panel is a mini-USB data port covered by a rubber flap with a raised lightning bolt symbol and raised USB symbol. The port is used for charging the battery and downloading information to a computer using Fora's software. On the right corner there is a slot for a lanyard.

Solo V2

The Solo V2 from BioSense Medical Devices ($17) weighs 2.2 ounces and measures 3.92 by 2.16 by 0.71 inches. The Solo V2 has a 1.5-inch by 1.9-inch monochrome black-on-gray display with two buttons below the display and three buttons on the top of the right side panel. The power button is the left button located below the display. It is used to turn the meter on and off and to recall previous test results. It has a non-tactile icon that resembles a calendar. The repeat button is the right button located below the display. It is used to repeat the last spoken message or test result and has a non-tactile arrow pointing left. The buttons below the display are connected in the middle and are not actually physically separated from each other. The speaker is located below these buttons. On the top of the right side panel are two directional buttons and one button for settings. The directional buttons are located at the very top and have raised arrows pointing up and down. They are used to select different test results, change settings, and increase or decrease the volume. The settings button, which is small and circular, is located below the directional button on the top right side panel. On the bottom of the right side panel, there is a mini-USB data port used for downloading test results to a computer using BioSense Medical Devices' software.

Evaluation Methodology

As with our past evaluations of blood glucose meters, we evaluated how easily a person who is blind or has low vision could perform each task and access each feature and function of the meters. We evaluated each meter in the following seven areas:

• Obtaining a blood glucose measurement
• Accessing past readings in memory
• Settings
• Software
• Documentation
• Warnings and error messages
• Low Vision Accessibility

Results

Although all four meters have high-quality recorded human speech that supports all of their features and functions, there are some differences in overall ease of use.

Obtaining a Blood Glucose Measurement

The process of obtaining a blood glucose measurement is fully accessible on all four of these meters, with speech output supporting the process the entire way. All models:

• Speak test results in only 6 or 7 seconds
• Have a repeat button in case you miss something that is spoken
• Alert you if your reading is out of the normal healthy range
• Automatically work with their strips (no need to code the meter for each new bottle of strips)
• Use strips with capillary action, which pulls your blood sample into the strip, eliminating the need to place a large hanging drop of blood onto the strip
• Have a tactile notch to indicate where to insert the strip; the strips protrude enough from the meters so that you don't have to clean the meters after use

All four meters require a small sample of blood: the Prodigy Voice requires 0.6 microliters and the others require 0.7 microliters. The two Fora meters have a handy eject button, so you can dispose of used strips without touching them. All but the Solo V2 have a headphone jack, which is useful for private use or for attaching speakers to amplify the speech for a person who is hard of hearing.

Although it can be difficult to quantify how tactually identifiable a control button is, the buttons on the Prodigy Voice and the Fora V20 are definitely the easiest to distinguish from one another non-visually. The Solo V2's Memory and Back buttons are right next to each other and were somewhat difficult to distinguish from one another. Although the buttons on the Solo V2 for adjusting the Settings are easy to feel, it does take considerable force to activate them. Most of the buttons on the Fora V22 are nearly flush with the panel and so are difficult to feel and activate non-visually. However, even though the buttons on the Solo V2 and Fora V22 can be somewhat difficult to use, proper practice should make those meters usable with no problems.

Accessing Past Readings in Memory

The memory functions of the Prodigy Voice and both Fora meters are fully accessible and supported entirely by speech output. It's easy to scroll through the individual records to hear the glucose level, time, and date for each reading. The memory function of the Solo V2 is not quite as fully accessible, because it will not speak the time of each reading, even though the time is shown visually on the display screen. All four meters will speak their 7, 14, 21, 28, 60, and 90 day averages, and the Solo V2 can hold 500 readings in memory while the others can hold 450 readings.

Settings

The process for adjusting the various settings on all of these meters is accessible, with speech supporting all the steps along the way.

On the Prodigy Voice, you can adjust the volume, date, and time, and you can choose between mg/dL and mmol/L as the measurement unit. The Prodigy Voice's settings also allow you to delete your readings from memory. The Fora and Solo V2 meters include those settings and an additional language setting, and the Solo V2 also has an alarm setting as well.

Software

All four meters have free software available for transferring results to a PC. The software creates charts and graphs for monitoring your test history and prepares reports that you can send to your health care provider so he or she can track your blood sugar levels over time.

The PC software for the two Fora meters is not compatible with screen reading technology at all, but parts of the Prodigy Voice and Solo V2 software are compatible. The Prodigy Voice has more compatible components than the Solo V2. Although neither allows a screen reader user to access reports of test results, both can export the reports to accessible spread sheets.

Documentation

The Prodigy Voice, the Solo V2, and the Fora V22 all have manuals available in an electronic format that is compatible with screen reading software used by people with vision loss. The electronic manual for the Fora V20, however, contains several graphics and important instructions that can't be accessed.

Warnings and Error Messages

All four meters speak the warnings and error messages that are occasionally displayed on their screens. You know that you've inserted a strip incorrectly when the meters do not speak their instructional messages after insertion. The Prodigy Voice and Solo V2 also have the added benefit of a "Not enough blood" warning, which can help people with vision loss avoid false low test results.

Low Vision Accessibility

All of these meters feature monochromatic displays with large fonts that should be readable by many people with low vision. The Solo V2 leads the way with very large, 1- inch tall characters; the Prodigy Voice's display uses 0.63-inch characters; the characters on both Fora displays are 0.55 inches tall. Contrast is another strong indicator of readability, and the Prodigy's display leads the way with a high 83.6% contrast ratio. The Solo V2 has a fairly high contrast ratio at 73.9%; the Fora meters have a low 53% ratio. Of course, the speech output on these meters will accommodate a person whose vision is such that he or she cannot read the display screen.

As far as the visual nature of the other physical characteristics of these meters, our testers with low vision said that the labels on the buttons are too small for most people with low vision to read. Also, the button labels on both monitors are nearly the same color as the buttons themselves, providing no contrast to accommodate the reader with low vision. Many people with low vision may need to use tactile methods to identify and use the buttons on these meters.

The Bottom Line

All four of the meters evaluated in this article are usable by people with vision loss, but the testers in our AFB Tech labs found the Prodigy Voice to be the most accessible of the four. Overall, the Prodigy Voice did a bit better than the others in the seven areas we tested.

Things have certainly improved with blood glucose meter accessibility since we began tracking it in our AFB Tech labs nearly ten years ago. Back then, meters all had displays with poor readability, and the only meter with speech output that used modern technology was a large $500 contraption you had to carry around in a backpack. Now we have four highly portable meters with comprehensive speech output from which to choose, and all of them have improved visual displays. That said, none of these talking meters are among the most popular in use today; none of the four we tested are among the top selling meters as listed by Amazon.com. This is an ongoing problem for people who have diabetes and vision loss, because the most popular meters, such as the Accu-Chek Compact and the One Touch Ultra 2, are far more likely to be prescribed by physicians and are also more likely to be covered by insurance carriers. When the leading BGM manufacturers build accessible meters, more people with vision loss will have greater access to the proper tools to independently manage their diabetes.

Resources

The Websites we provide in the next section for both the Prodigy Voice and Solo V2 contain some very useful training resources. Also, AFB's own Center for Vision Loss has developed the following resources:

Diabetes Basics
Diabetes and Vision Loss

The Carroll Center has added a third course on diabetes to its online offerings. Diabetes and Visual Impairment: A New View for Health Professionals is currently free, accessible to all who wish to enroll, and various accrediting agencies provide continuing education credits.

Product Information

Product:Prodigy Voice
Available from:Prodigy Diabetes Care, LLC
Address:
P.O. Box 481928
Charlotte, NC 28269
24/7 Customer Care Center: (800) 243-2636
Sales: (866) 540-4786

Product:Solo V2
Available from:BioSense Medical Devices
Address:
6555 Sugarloaf Pkwy, Suite 307-168
Duluth, GA 30097
Phone: (877) 592-3922
E-mail:info@biosensemd.com

Product:Fora V20 and Fora V22
Address:
810 Lawrence Drive, Suite 104
Newbury Park, CA 91320 USA
Phone: 1-888-307-8188 or (866) 469-2632
E-mail:service@foracare.com

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